酒精性肝硬化合并肝炎病毒感染的临床特点

目的:探讨酒精性肝硬化(ALC)合并肝炎病毒感染的临床发病特点。方法:对我院1994年至2003年收治的237例ALC患者的临床资料进行分析。结果:237例ALC患者合并肝炎病毒感染79例(33.3%),其中乙肝病毒感染67例(28.3%),丙肝病毒(HBV)感染8例(3.4%),乙肝与丙肝病毒混合感染4例(1.7%),无肝炎病毒感染158例(66.7%);感染组的出血和肝性脑病发生率与非感染组相比差异显著(P<0.025);感染组血清AST、ALT明显升高的比率分别是38%和22.8%,非感染组分别是22.8%、8.8%,两组比较差异显著(P<0.025);感染组肝癌的发生率为19.3%,而非感染组仅为1.9%,两组比较差异显著(P<0.01)。结论:酒精与肝炎病毒在肝损伤过程中起协同作用,肝炎病毒感染增加了ALC肝癌发生的机会。

Clinical characteristics of alcoholic liver cirrhosis cases infected with hepatitis viruses

Objective To explore the clinical characteristics of ALC cases infected with hepatitis viruses. Method 237 ALC cases from 1994 to 2003 were analyzed. Results 79 of 237 ALC cases (33.3%) were infected with hepatitis viruses, among which, 67 were infected with HBV , 8 HCV, and 4 coinfected with HBV and HCV. The significant deviation was shown in incidence rate of upper gastrointestinal hemorrhage and hepatic encephalopathy between infected group and non-infected group (P<0.025). AST and ALT rised greatly in 38% and 22% patients in infected group, while in non-infected group, they were 22.8% and 8.8%. AST and ALT raised more greatly in infected group than in non-infected group. Significant deviation was shown in the incidence rate of hepatic cellular cancer (HCC) between infected group (19.3%) and non-infected group (1.9%). Conclusion Alcoholic and hepatitis viruses play a role of synergistic action in causing damage to liver. ALC patients infected with hepatitis viruses were easy to develop hepatic cellular cancer (HCC).